Provider Demographics
NPI:1457461105
Name:SINGH, RAJEEV (MD)
Entity Type:Individual
Prefix:
First Name:RAJEEV
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BRENTSHIRE SQ
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2203
Mailing Address - Country:US
Mailing Address - Phone:731-664-0994
Mailing Address - Fax:731-664-0866
Practice Address - Street 1:1999 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3630
Practice Address - Country:US
Practice Address - Phone:901-476-4457
Practice Address - Fax:901-475-4389
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41497207Q00000X
TNMD41497207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4355442OtherCIGNA
TN4134914OtherBLUE CROSS BLUE SHIELD
TN626001636OtherBAPTISIT HEALTH SERVICE G
TN10026976OtherUAHC
TN3822078Medicaid
TN38135OtherTLC
626001636OtherUSA MANAGED CARE
TN4134914OtherBLUE CROSS BLUE SHIELD
TN3822078Medicare ID - Type Unspecified